electrolyte panel Flashcards
Sodium (Na) =
Primary determinant of extracellular fluid volume.
Sodium reference values =
134-142 mEq/L
Sodium (Na) Hypernatremia =
sodium level > 145 mEg/L
Trending Upward
Sodium (Na) Hypernatremia
causes:
Increased sodium intake
Severe vomiting CHF
Renal insufficiency
Cushing’s syndrome
Diabetes
Sodium (Na) Hypernatremia
presentation:
Irritability
Agitation
Seizure
Coma
Hypotension
Tachycardia
Decreased urinary output
Sodium (Na) Hypernatremia
clinical implications:
Impaired cognitive status
Seizure precautions for patients with past medical history
Sodium (Na) Hyponatremia =
(sodium level < 130mEq/L)
Trending Downward
Sodium (Na) Hyponatremia
causes:
Diuretic use
Gastrointestinal
impairment
Burns/wounds
Hypotonic IV use
Cirrhosis
Sodium (Na) Hyponatremia
presentation:
Headache
Lethargic
Decreased reflexes
Nausea and vomiting (N/V) Diarrhea
Seizure
Coma
Orthostatic hypotension
Pitting edema
Sodium (Na) Hyponatremia
clinical implications:
Impaired cognitive status
Monitor vitals secondary to risk for orthostatic hypotension
Potassium (K) =
Important for function of excitable cells such as nerves, muscles, and heart
Potassium (K) reference values =
3.7-5.1 mEq/L
Potassium (K) Hyperkalemia =
(serum potassium levels > 5.5 mEq/L)
Trending Upward
Potassium (K) Hyperkalemia
causes:
Renal failure
Metabolic acidosis
Diabetic ketoacidosis (DKA) Addison’s disease
Excess potassium supplements
Blood transfusion
Potassium (K) Hyperkalemia
presentation:
Muscle weakness/paralysis Paresthesia
Bradycardia
Heart block
Ventricular fibrillation
Cardiac arrest
Potassium (K) Hyperkalemia
clinical implications:
Patient at risk for cardiac issues > 5 mEq/L: Use symptoms-based approach when determining appropriateness for activity
Might exhibit muscle weakness during intervention
Potassium (K) Hypokalemia =
(serum potassium levels < 3.5 mEq/L)
Trending Downward
Potassium (K) Hypokalemia
causes:
Diarrhea/vomiting Gastrointestinal impairment Diuretics
Cushing’s syndrome Malnutrition
Restrictive diet
ETOH abuse
Potassium (K) Hypokalemia
presentation:
Extremity weakness
Decreased reflexes
Paresthesia
Leg cramps
EKG changes
Cardiac arrest
Hypotension
Constipation
Potassium (K) Hypokalemia
clinical implications:
Severe hypokalemia < 2.5 mEq/L: collaborate with interprofessional team
Calcium (Ca) =
Important for bone formation, cell division and growth, blood coagulation, muscle contraction, and release of neurotransmitters
Calcium (Ca) reference values =
8.6-10.3 mg/dL
Calcium (Ca) Hypercalcemia =
(high levels of calcium in blood) Trending Upward
Calcium (Ca) Hypercalcemia
causes:
Excessive calcium supplements/antacids
Bone destruction – tumor
Immobilization Fracture
Excessive vitamin D
Cancer
Renal failure
Calcium (Ca) Hypercalcemia
presentation:
Ventricular dysrhythmias
Heart block
Asystole
Coma
Lethargy
Muscle weakness
Decreased reflexes Constipation
Nausea/vomiting
Calcium (Ca) Hypocalcemia =
(low levels of calcium in blood) Trending Downward
Calcium (Ca) Hypocalcemia
causes:
ETOH abuse
Poor dietary intake
Limited GI absorption Pancreatitis
Laxative use
Calcium (Ca) Hypocalcemia
presentation:
Anxiety
Confusion
Agitation
Seizure
EKG changes
Fatigue
Numbness/tingling
Increased reflexes
Muscle cramps
Chloride (Cl) =
Important for fluid balance and acid base status
Chloride (Cl) reference values =
98-108 mEq/L
Chloride (Cl) Hyperchloremia =
(high levels of chloride in blood) Trending Upward
Chloride (Cl) Hyperchloremia
causes:
High-salt, low-water diet Hypertonic IV
Metabolic Acidosis
Renal failure
Chloride (Cl) Hyperchloremia
presentation:
Lethargy
Decreased level of consciousness
Weakness
Edema
Tachypnea
Hypertension (HTN) Tachycardia
Hypochloremia =
(low levels of chloride in blood) Trending Downward
Chloride (Cl) Hypochloremia
causes:
Low salt diet
Water intoxication
Diuresis
Excessive vomiting and/or diarrhea
Chloride (Cl) Hypochloremia
presentation:
Agitation
Irritability
Hypertonicity
Increased reflexes
Cramping Twitching
Phosphate (PO4) =
Necessary for bone formation, acid-base balance, and storage and transfer of energ
Phosphate (PO4) reference values =
2.3-4.1 mg/dL
Phosphate (PO4) Hyperphosphatemia =
(high level of phosphate in blood)
Trending Upward
Phosphate (PO4) Hyperphosphatemia
causes:
Bone destruction – tumor
Immobilization Fracture
Excessive vitamin D
Cancer
Renal failure
Phosphate (PO4) Hyperphosphatemia
presentation:
Ventricular dysrhythmia
Heart block
Asystole
Coma
Lethargy
Muscle weakness
Decreased reflexes Constipation
Nausea/vomting
Phosphate (PO4) Hypophosphatemia =
(low level of phosphate in blood)
Trending Downward
Phosphate (PO4) Hypophosphatemia
causes:
ETOH abuse
Poor dietary Intake
Limited GI absorption Pancreatitis
Laxative Use
Phosphate (PO4) Hypophosphatemia
presentation:
Anxiety
Confusion
Agitation
Seizure
EKG changes
Fatigue
Numbness/tingling Increased reflexes
Muscle cramps
Magnesium (Mg) =
Concentrated in bone and muscle; concentration primarily regulated by kidneys (ordered separately from BMP)
Magnesium (Mg) reference values =
1.2-1.9 mEq/L
Magnesium (Mg) Hypermagnesemia =
(high level of magnesium in blood)
Trending Upward
Magnesium (Mg) Hypomagnesemia
causes:
Increased intake of antacids/magnesium citrate
Renal failure
Leukemia
Dehydration
Magnesium (Mg) Hypomagnesemia
presentation:
Diaphoresis
N/V
Drowsiness
Lethargy
Weakness flaccidity
Decreased reflexes Hypotension
Heart block
Magnesium (Mg) Hypomagnesemia =
(low level of magnesium in blood)
Trending Downward
Magnesium (Mg) Hypomagnesemia
causes:
ETOH abuse
Eating disorders
Diuresis
DKA
Medications
Magnesium (Mg) Hypomagnesemia
presentations:
Increased reflexes
Tremors
Spasticity
Seizures
Nystagmus
EKG changes (premature ventricular contraction (PVC) -> v tach -> v fib )
Emotional lability
